Promoting health and function in an ageing population

This is the second in a series of four articles To ensure the health and wellbeing of the growing numbers and proportion of older people during the opening decades of the new century will require greater effort in health promotion and disease prevention in old age. This article reviews evidence of the effectiveness of strategies for promoting health and function, particularly the benefits of exercise in old age. #### Summary points Evidence points to an overall decline in the prevalence of disability in successive cohorts of older people For maintaining health and function in ageing, the social, mental, economic, and environmental determinants of health in old age must be taken into account The health benefits of exercise may often relate to psychosocial as well as direct health gains Most of the health benefits can be gained from regular physical activity of moderate intensity Health and wellbeing at older ages is modifiable, and substantial gains could be made by promoting health and fitness throughout life The extent to which age, chronic disease, and disability are interrelated—and the extent to which population ageing is inevitably accompanied by increased prevalence of chronic disease and disability among older people—remains controversial. In the early 1980s Fries argued that there would be an upper limit to life expectancy but that the onset of morbidity (illness and incapacity) could ultimately be postponed until about the age of 85 and there would thus be a “compression of morbidity.”1 The period of healthy life would thus be extended, he postulated, and the period of morbidity could potentially be “compressed” into the brief interlude …